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Sahni M, Goyal S, Devgarha S, Sisodiya A. Askin's Tumor in the Chest Wall-a Rare Clinical Entity and Review of Literature. Indian J Surg Oncol 2024; 15:409-413. [PMID: 38741636 PMCID: PMC11088598 DOI: 10.1007/s13193-024-01921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/05/2024] [Indexed: 05/16/2024] Open
Abstract
Askin tumors are the rare malignancy of neuroectodermal origin of the thoracic wall. Its prevalence is more in younger age group who present with vague symptoms leading to delayed diagnosis. We hereby present a case report of complex management of large chest wall tumor in a young boy and review the literature of this entity.
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Affiliation(s)
- Manish Sahni
- Department of Surgical Oncology, SMS Medical College and Hospital, Jaipur, Rajasthan India
| | - Shefali Goyal
- Department of Cardiovascular and Thoracic Surgery, SMS Medical College and Hospital, Jaipur, Rajasthan India
| | - Sanjeev Devgarha
- Department of Cardiovascular and Thoracic Surgery, SMS Medical College and Hospital, Jaipur, Rajasthan India
| | - Anula Sisodiya
- Department of Cardiovascular and Thoracic Surgery, SMS Medical College and Hospital, Jaipur, Rajasthan India
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Das KJ, Kumar A, Prakash S, Singhal A. Askin's Tumor a Rare Clinical Entity of Thoracopulmonary Region Cresenting as a Case of Paraparesis: Findings on 18F-FDG PET/CT. Indian J Nucl Med 2023; 38:148-150. [PMID: 37456194 PMCID: PMC10348496 DOI: 10.4103/ijnm.ijnm_181_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/14/2022] [Accepted: 12/24/2022] [Indexed: 07/18/2023] Open
Abstract
Askin's tumors are rare malignant neoplasms located in the thoracopulmonary region and mainly occur in children and adolescents. In this report, we describe a case of histologically proven Askin's tumor in a 24-year-old male. The patient was admitted with a history of 3-month lower back pain and with a rare presentation of paraparesis.
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Affiliation(s)
- Kalpa Jyoti Das
- Department of Nuclear Medicine, National Cancer Institute, All India Institute of Medical Sciences, Jhajjar, Haryana, India
| | - Akash Kumar
- Department of Medical Oncology, National Cancer Institute, All India Institute of Medical Sciences, Jhajjar, Haryana, India
| | - Sneha Prakash
- Department of Nuclear Medicine, National Cancer Institute, All India Institute of Medical Sciences, Jhajjar, Haryana, India
| | - Abhinav Singhal
- Department of Nuclear Medicine, National Cancer Institute, All India Institute of Medical Sciences, Jhajjar, Haryana, India
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Iwamoto S, Kadowaki T, Nagaoka S, Minamizaki T, Tajima F, Nishikawa E, Tada M, Kimura M, Kobayashi K, Ikeda T, Yano S. Askin's tumor in an elderly patient. Geriatr Gerontol Int 2019; 19:958-960. [PMID: 31490006 DOI: 10.1111/ggi.13727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/28/2019] [Accepted: 06/07/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Shinichi Iwamoto
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Toru Kadowaki
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Saburo Nagaoka
- Department of Laboratory Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Takeshi Minamizaki
- Department of Orthopedics, National Hospital Organization Yonago Medical Center, Yonago, Japan
| | - Fumihito Tajima
- Stem Cell Transplantation Center, National Hospital Organization, Yonago Medical Center, Yonago, Japan
| | - Emiko Nishikawa
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Mitsuhiro Tada
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Masahiro Kimura
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Kanako Kobayashi
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Toshikazu Ikeda
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
| | - Shuichi Yano
- Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Japan
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Triarico S, Attinà G, Maurizi P, Mastrangelo S, Nanni L, Briganti V, Meacci E, Margaritora S, Balducci M, Ruggiero A. Multimodal treatment of pediatric patients with Askin's tumors: our experience. World J Surg Oncol 2018; 16:140. [PMID: 30005673 PMCID: PMC6044084 DOI: 10.1186/s12957-018-1434-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 06/26/2018] [Indexed: 11/30/2022] Open
Abstract
Background We report our experience and outcomes about the management of Askin’s tumors [AT], which are rare primitive neuroectodermal tumors (PNETs) that develop within the soft tissue of the thoracopulmonary region, typically in children and adolescents. Methods We retrospectively analyzed the charts of 9 patients affected by AT (aged 6–15 years), treated at the Paediatric Oncology Unit of Gemelli University Hospital in Rome between January 2001 and December 2016. Results All nine patients underwent to biopsy followed by neoadjuvant chemotherapy. At the end of the neoadjuvant chemotherapy, they underwent to surgical removal of the residual tumor. Five patients with positive tumor margins and/or necrosis< 90% received local radiotherapy. Two patients with metastasis received an intensified treatment, with the addition of high dose adjuvant chemotherapy followed by peripheral blood stem cells rescue. No statistically significant correlation was found between outcome and gender; the presence of any metastasis and the radiotherapy. The overall survival was 65.14 months (95% confidence interval [95%CI], 45.81–84.48), and the 5 years survival was 60%, at a median follow-up of 53.1 months. Conclusion Our study confirms that a multimodal treatment with surgery, chemotherapy, and radiotherapy may increase the survival in AT pediatric patients.
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Affiliation(s)
- Silvia Triarico
- Paediatric Oncology Unit, A. Gemelli University Hospital, Catholic University of Sacred Hearth, Largo A. Gemelli, 8, 00168, Rome, Italy.
| | - Giorgio Attinà
- Paediatric Oncology Unit, A. Gemelli University Hospital, Catholic University of Sacred Hearth, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Palma Maurizi
- Paediatric Oncology Unit, A. Gemelli University Hospital, Catholic University of Sacred Hearth, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Stefano Mastrangelo
- Paediatric Oncology Unit, A. Gemelli University Hospital, Catholic University of Sacred Hearth, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Lorenzo Nanni
- Pediatric Surgery Unit Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy
| | - Vito Briganti
- Pediatric Surgery Unit, San Camillo Forlanini Hospital, Rome, Italy
| | - Elisa Meacci
- Thoracic Surgery Unit, Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy
| | - Stefano Margaritora
- Thoracic Surgery Unit, Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy
| | - Mario Balducci
- Radiotherapy Unit, Gemelli University Hospital, Catholic University of Sacred Heart, Rome, Italy
| | - Antonio Ruggiero
- Paediatric Oncology Unit, A. Gemelli University Hospital, Catholic University of Sacred Hearth, Largo A. Gemelli, 8, 00168, Rome, Italy
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5
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18 F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Marroquín JA, Hernández AC, Pilkington JP, Saviatto A, Tabuenca MJ, Estenoz JM. 18F-FDG PET/CT in a cardiac metastasis in a patient with history of malignant neuroectodermal tumour of the chest wall: Case report and review of the literature. Rev Esp Med Nucl Imagen Mol 2017. [PMID: 28648525 DOI: 10.1016/j.remn.2017.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The case presented is a 25-year-old male with a malignant neuroectodermal tumour on the left chest wall (Askin tumour), treated with surgery after neoadyuvant chemotherapy and followed by consolidation chemotherapy. After 9 years of disease free survival, the patient developed an acute pulmonary embolism. The echocardiogram, thoracic CT, and cardiac MRI scans revealed a mass in the right atrium. Recurrence of an Askin tumour versus an atrium myxoma was suspected. 18F-FDG PET/CT showed an intense hypermetabolic right atrium mass with extension to the right ventricle highly suggestive of malignancy. The result of the histopathology examination after biopsy and subsequently exeresis of the right atrium mass was consistent with a metastasis of the primary tumour.
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Affiliation(s)
- J A Marroquín
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España.
| | - A C Hernández
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - J P Pilkington
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - A Saviatto
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - M J Tabuenca
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
| | - J M Estenoz
- Servicio de Medicina Nuclear, Hospital Universitario 12 de Octubre , Madrid, España
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Pek CH, Ho SYM, Cheong EC. Askin tumor: a rare chest wall sarcoma in an Asian adult patient—a literature review and a suggested treatment protocol. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-1006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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8
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Dong A, Wang Y, Lu J, Zuo C. FDG PET/CT in Peripheral Primitive Neuroectodermal Tumor of the Retroperitoneum. Clin Nucl Med 2014; 39:707-10. [DOI: 10.1097/rlu.0b013e318292f38e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The aim of the study was to describe the imaging findings of Askin tumors on computed tomography (CT) and fluorine 18 fluorodeoxyglucose-positron emission tomography (FDG-PET/CT).Seventeen cases of Askin tumors confirmed by histopathology were retrospectively analyzed in terms of CT (17 cases) and FDG-PET/CT data (6 cases).Fifteen of the tumors were located in the chest wall and the other 2 were in the anterior middle mediastinum. Of the 15 chest wall cases, 13 demonstrated irregular, heterogeneous soft tissue masses with cystic degeneration and necrosis, and 2 demonstrated homogeneous soft tissue masses on unenhanced CT scans. Two mediastinal tumors demonstrated the irregular, heterogeneous soft tissue masses. Calcifications were found in 2 tumors. The tumors demonstrated heterogeneously enhancement in 16 cases and homogeneous enhancement in 1 case on contrast-enhanced scans. FDG-PET/CT images revealed increased metabolic activity in all 6 cases undergone FDG-PET/CT scan, and the lesion SUVmax ranged from 4.0 to 18.6. At initial diagnosis, CT and FDG-PET/CT scans revealed rib destruction in 9 cases, pleural effusion in 9 cases, and lung metastasis in 1 case. At follow-up, 12 cases showed recurrence and/or metastases, 4 cases showed improvement or remained stable, and 1 was lost to follow-up.In summary, CT and FDG-PET/CT images of Askin tumors showed heterogeneous soft tissue masses in the chest wall and the mediastinum, accompanied by rib destruction, pleural effusion, and increased FDG uptake. CT and FDG-PET/CT imaging play important roles in the diagnosis and follow-up of patients with Askin tumors.
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Affiliation(s)
- Tingting Xia
- Department of Radiology (TX, YG, JL), The First Affiliated Hospital of GuangZhou Medical University, Guangzhou, 510120; Department of Radiology (YC), State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, 510060, PR China
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Santhosh S, Kashyap R, Bhattacharya A, Kumar Jindal S, Rai Mittal B. Role of F18 fluorodeoxyglucose positron-emission tomography/computed tomography in the management of Askin's tumor. Indian J Nucl Med 2013; 28:180-2. [PMID: 24250031 PMCID: PMC3822422 DOI: 10.4103/0972-3919.119548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A primitive neuroectodermal tumor (PNET) of the thoraco-abdominal region is one of a group of small round cell tumors usually found in children and young adults, originally described by Askin et al. Most cases arise in the soft-tissues of the thorax, but may rarely occur within the lung with the symptoms of chest wall pain, pleural effusion and dyspnea. The authors present two cases demonstrating the utility of F18 fluorodeoxyglucose positron-emission tomography/computed tomography in the staging and prognosis of PNET of the chest wall.
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Affiliation(s)
- Sampath Santhosh
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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DOU XUE, YAN HONGJIANG, WANG RENBEN. Treatment of an Askin tumor: A case report and review of the literature. Oncol Lett 2013; 6:985-989. [PMID: 24137450 PMCID: PMC3796431 DOI: 10.3892/ol.2013.1488] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 07/12/2013] [Indexed: 12/03/2022] Open
Abstract
Askin tumors are rare malignant neoplasms that are localized in the thoracopulmonary region and mainly occur in children and adolescents. Further investigation with regard to the effective treatment of this disease is required, since the disease has a low incidence and limited knowledge is available on the biological activity and prognostic factors of this type of tumor. The present study describes the case of a 30-year-old male patient with a histologically and morphologically proven Askin tumor who was treated in Shandong Cancer Hospital and Institute (Jinan, China). A chest computed tomography (CT) scan demonstrated a large mass filling the entire left lung, associated with mediastinum and right lung compression and accompanied by destruction of the 2nd rib. The patient accepted chemotherapy and radiotherapy instead of a radical mass resection since the mass was irresectable. A good clinical response was achieved to the chemotherapy and radiotherapy. The diagnosis and treatment of Askin tumors remains a challenge for clinicians and surgeons due to the absence of standard therapeutic guidelines for the treatment of this disease. According to the experience obtained from the cases encountered to date, treatment strategies should aim to reduce local recurrence and distant metastasis. Moreover, surgery, chemotherapy and radiotherapy or a combination of these methods appears to constitute an effective treatment strategy for Askin tumors.
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Affiliation(s)
- XUE DOU
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China
| | - HONGJIANG YAN
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China
| | - RENBEN WANG
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan, Shandong 250117, P.R. China
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Xu Q, Xu K, Yang C, Zhang X, Meng Y, Quan Q. Askin tumor: four case reports and a review of the literature. Cancer Imaging 2011; 11:184-8. [PMID: 22138531 PMCID: PMC3266582 DOI: 10.1102/1470-7330.2011.0025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Askin tumor is an uncommon malignant neoplasm in the thoracopulmonary region mainly occurring in children and adolescents. Four young patients with histologically proven Askin tumors were treated in our hospital. In all patients, chest computed tomography imaging demonstrated a chest wall mass with or without destruction of ribs. All patients underwent radical mass resection and postoperative chemotherapy. By the time this article was completed, two of the patients had died with local chest wall recurrences. Here we focus on the imaging features, differential diagnosis, pathology and prognosis of this rare disease.
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Affiliation(s)
- Qian Xu
- Department of Radiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, PR China
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